Study on Normal Laryngeal Electromyography of Thyroarytenoid Muscle, Cricothyroid Muscle, and Posterior Cricoarytenoid Muscle

2018 ◽  
Vol 127 (11) ◽  
pp. 806-811
Author(s):  
Xinlin Xu ◽  
Pan Yang ◽  
Peiyun Zhuang ◽  
Jiao Yanchao ◽  
Ma Yanli ◽  
...  
Keyword(s):  
Motor Unit ◽  
Physiological Activity ◽  
Motor Unit Potential ◽  
Deep Inspiration ◽  
Laryngeal Electromyography ◽  
Cricothyroid Muscle ◽  
Posterior Cricoarytenoid Muscle ◽  
Intrinsic Laryngeal Muscle ◽  
Posterior Cricoarytenoid ◽  
Thyroarytenoid Muscle

Objective: The aim of this study was to investigate the physiological activity of intrinsic laryngeal muscle under different functional states of larynx by measuring the normal laryngeal electromyography parameters. Methods: Laryngeal electromyography (EMG) was performed in 112 patients with unilateral vocal cord movement disorder. The duration and amplitude of the motor unit potential (MUP) of the thyroarytenoid muscle (TA), posterior cricoarytenoid muscle (PCA), and cricothyroid muscle (CT) were measured when patients were asked to make a deep inspiration and phonate /i/. The normal side of the patients’ vocal chords was used as the research object. Results: (1) The motor unit potential of TA, CT, and PCA were measured when inspiration and phonating /i/. Waveforms were normal. (2) There were significant differences in duration of TA between inspiration and phonating /i/ in comfortable tone. (3) When comparing the duration and amplitude of any 2 of TA, CT, and PCA during inspiration and phonating /i/, there were significant differences in duration between CT and PCA when phonating /i/ only. There were no significant differences in any other comparisons. Conclusions: Under either deep inspiration or pronunciation, the TA, CT, and PCA muscles were activated. The TA may play a major role in phonating. The PCA may play a major role in the action of deep inspiration.

Value of Laryngeal Electromyography in Diagnosis of Vocal Fold Immobility

2007 ◽  
Vol 116 (8) ◽  
pp. 576-581 ◽  
Author(s):  
Wen Xu ◽  
Demin Han ◽  
Lizhen Hou ◽  
Li Zhang ◽  
Gongwei Zhao
Keyword(s):  
Vocal Fold ◽  
Motor Unit Potential ◽  
Laryngeal Electromyography ◽  
Potential Measurement ◽  
Laryngeal Paralysis ◽  
Posterior Cricoarytenoid Muscle ◽  
Lower Amplitude ◽  
Vocal Fold Immobility ◽  
Posterior Cricoarytenoid ◽  
Thyroarytenoid Muscle

Objectives: We sought to determine the value of laryngeal electromyography (LEMG) and evoked LEMG in the diagnosis of vocal fold immobility. Methods: We analyzed 110 cases of vocal fold immobility by their clinical manifestations and LEMG characteristics, including spontaneous potential activity, motor unit potential measurement, recruitment pattern analysis, and evoked LEMG signals. Results: With LEMG, we identified 87 patients with neuropathic laryngeal injuries. Neurogenic vocal fold immobility showed a wide variety of abnormal activity. Fibrillation potentials and positive sharp waves were found in patients with laryngeal nerve injuries. For laryngeal paralysis, there was no reaction with LEMG and evoked LEMG. For incomplete laryngeal paralysis, decreased evoked LEMG signals were also seen with delayed latency (thyroarytenoid muscle, 2.2 ± 1.0 ms, p < 01; posterior cricoarytenoid muscle, 2.4 ± 1.0 ms, p < .05) and lower amplitude (thyroarytenoid muscle, 0.9 ± 0.7 mV, p < .05; posterior cricoarytenoid muscle, 1.2 ± 1.0 mV, p < .01). Nineteen patients with vocal fold mechanical limitations generally had normal LEMG and evoked LEMG signals. Four patients with neoplastic infiltration of the laryngeal muscles demonstrated abnormal LEMG signals but nearly normal evoked LEMG signals. Conclusions: We conclude that LEMG and evoked LEMG behavior plays a crucial role in the diagnosis of vocal fold immobility. The decreased recruitment activities on LEMG and the decreased evoked LEMG signals with longer latency and lower amplitude reflect the severity of neuropathic laryngeal injury.

Timing of Glottic Closure during Swallowing: A Combined Electromyographic and Endoscopic Analysis

2005 ◽  
Vol 114 (6) ◽  
pp. 478-487 ◽  
Author(s):  
Douglas J. Van Daele ◽  
Timothy M. McCulloch ◽  
Phyllis M. Palmer ◽  
Susan E. Langmore
Keyword(s):  
Human Subjects ◽  
Case Series ◽  
Video Frame ◽  
Electromyographic Activity ◽  
Healthy Human ◽  
Glottic Closure ◽  
Posterior Cricoarytenoid Muscle ◽  
Multiple Trials ◽  
Posterior Cricoarytenoid ◽  
Thyroarytenoid Muscle

Objectives: We performed a case series to enhance our understanding of the coupling between neuromuscular events and glottic closure. Methods: We performed combined flexible video laryngoscopy and electromyography in 4 healthy human subjects. Hooked-wire electrodes were placed in the superior pharyngeal constrictor, longitudinal pharyngeal, cricopharyngeus, thyroarytenoid, genioglossus, suprahyoid, and posterior cricoarytenoid muscles. A flexible endoscope tip was positioned in the oropharyngeal-hypopharyngeal region. The subjects performed multiple trials each of 10-mL normal and super-supraglottic liquid swallows. Results: Arytenoid movement consistently preceded full glottic closure and was associated with cessation of activity of the posterior cricoarytenoid muscle. In 89% of normal swallows, the glottis was partially open in the video frame before bolus passage. The maximum amount of thyroarytenoid electromyographic activity occurred during endoscopic white-out. When subjects executed a super-supraglottic swallow, early thyroarytenoid activity coincided with arytenoid contact. Conclusions: The initial medialization of the arytenoids is due to a decrease in motor tone of the posterior cricoarytenoid muscle. Full glottic closure typically occurs late in the process of swallowing, with activation of the thyroarytenoid muscle. Shifting of arytenoid medialization and glottic closure earlier in the super-supraglottic swallow indicates that glottic closure is under significant voluntary control.

scholarly journals Suppression of Thyroarytenoid Muscle Responses during Repeated Air Pressure Stimulation of the Laryngeal Mucosa in Awake Humans

2005 ◽  
Vol 114 (4) ◽  
pp. 264-270 ◽  
Author(s):  
Pamela Reed Kearney ◽  
Eric A. Mann ◽  
Christopher J. Poletto ◽  
Christy L. Ludlow
Keyword(s):  
Air Pressure ◽  
Repeated Presentation ◽  
Repeated Stimulation ◽  
Laryngeal Mucosa ◽  
Posterior Cricoarytenoid Muscle ◽  
Interstimulus Intervals ◽  
Posterior Cricoarytenoid ◽  
Muscle Responses ◽  
Thyroarytenoid Muscle ◽  
Stimulation Of

Repeated stimulation of the laryngeal mucosa occurs during speech. Single stimuli, however, can elicit the laryngeal adductor response (LAR). Our hypothesis was that the LAR to repeated rapid air pressure stimuli is centrally suppressed in humans. Hookedwire electrodes were inserted into the thyroarytenoid and cricothyroid muscles on both sides and into the posterior cricoarytenoid muscle on one side. Pairs of air puff stimuli were presented to the mucosa over the arytenoids at pressure levels three times threshold with interstimulus intervals from 250 to 5,000 ms. Bilateral thyroarytenoid responses occurred at around 150 ms to more than 70% of the initial stimuli. With repeated presentation at intervals of 2 seconds or less, the percent occurrence decreased to less than 40% and response amplitudes were reduced by 50%. Central suppression of adductor responses to repeated air puff stimuli may allow speakers to produce voice without eliciting reflexive spasms that could disrupt speech.

Laryngeal Synkinesis: Its Significance to the Laryngologist

1989 ◽  
Vol 98 (2) ◽  
pp. 87-92 ◽  
Author(s):  
Roger L. Crumley
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Basic Research ◽  
Laryngeal Electromyography ◽  
Bilateral Vocal Cord Paralysis ◽  
Laryngeal Function ◽  
Adductor Muscles ◽  
Posterior Cricoarytenoid Muscle ◽  
Posterior Cricoarytenoid ◽  
Intrinsic Laryngeal Muscles

Basic research and surgical cases have shown that the injured recurrent laryngeal nerve (RLN) may regenerate axons to the larynx that inappropriately innervate both vocal cord adductors and abductors. Innervation of vocal cord adductor muscles by those axons that depolarize during inspiration is particularly devastating to laryngeal function, since it produces medial vocal cord movement during inspiration. Many patients thought to have clinical bilateral vocal cord paralysis can be found to have synkinesis on at least one side. This will make the glottic airway smaller, particularly during inspiration, than would true paralysis of all the intrinsic laryngeal muscles. Patients with bilateral vocal cord paralysis should undergo laryngeal electromyography. If inspiratory innervation of the adductor muscles is present, simple reinnervation of the posterior cricoarytenoid muscle will fail. The adductor muscles also must be denervated by transection of the adductor division of the regenerated RLN.

Evoked Electromyographic Technique for Quantitative Assessment of the Innervation Status of Laryngeal Muscles

2005 ◽  
Vol 114 (7) ◽  
pp. 563-572 ◽  
Author(s):  
David L. Zealear ◽  
Matthew R. Swelstad ◽  
Scott Fortune ◽  
Ricardo J. Rodriguez ◽  
Sung-Min Chung ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Quantitative Information ◽  
Laryngeal Nerve ◽  
Noninvasive Technique ◽  
Laryngeal Muscles ◽  
Phase Study ◽  
Posterior Cricoarytenoid Muscle ◽  
Muscle Innervation ◽  
Posterior Cricoarytenoid ◽  
Thyroarytenoid Muscle

Objectives: The purpose of this study was to develop a minimally invasive, noninjurious evoked electromyographic technique that could accurately quantitate the level of innervation of laryngeal muscles with recurrent laryngeal nerve stimulation. Methods: A four-phase study was conducted in 24 canines, including 1) identification of the best stimulation-recording configuration, 2) statistical analysis of sensitivity and accuracy, 3) evaluation of safety, and 4) identification of the laryngeal muscle(s) that contribute to the evoked response. Results: The results demonstrated that an entirely noninvasive technique is not feasible. The stimulating cathode must be invasive to ensure discrete activation of the recurrent laryngeal nerve, whereas both recording electrodes should remain on the surface with one overlying the thyroid ala. This configuration proved to be highly accurate, with an error rate of only 6% to 7%, and with sensitivity sufficient to detect a signal in a nerve with fewer than 1% of the axons intact. There was no evidence of nerve injury in any animal over the course of 350 stimulus needle penetrations. By use of neuromuscular blockade to identify those muscles generating the surface response, the thyroarytenoid muscle was found to be the primary contributor, whereas the posterior cricoarytenoid muscle was uninvolved. Conclusions: This evoked electromyographic technique could provide quantitative information regarding the extent of muscle innervation during denervation and regeneration in case of laryngeal paralysis.

Thyroarytenoid muscle activity during hypocapnic central apneas in awake nonsedated lambs

1994 ◽  
Vol 76 (3) ◽  
pp. 1262-1268 ◽  
Author(s):  
I. Kianicka ◽  
J. F. Leroux ◽  
J. P. Praud
Keyword(s):  
Face Mask ◽  
Adductor Muscle ◽  
Emg Activity ◽  
Central Apnea ◽  
Upper Airways ◽  
Cricothyroid Muscle ◽  
Posterior Cricoarytenoid Muscle ◽  
Posterior Cricoarytenoid ◽  
Central Apneas ◽  
Arterial Po2

In this study, we examined whether the glottis is open or closed during central apnea and the effect of arterial PO2 (PaO2) on this control. We hyperventilated nine 11- to 30-day-old awake nonsedated lambs via a tracheostomy for 1 min to induce central apnea. Four gas mixtures (8, 15, 21, and 30% O2) were used. At the end of the hyperventilation period, the lambs were allowed to breathe spontaneously through intact upper airways. Using a pneumotachograph attached to a face mask, we measured airflow, and we continuously recorded electromyographic (EMG) activity of the thyroarytenoid (TA), the main glottic adductor muscle. We also studied the lateral cricoarytenoid muscle (LCA, laryngeal adductor), the posterior cricoarytenoid muscle (PCA, laryngeal abductor), the cricothyroid muscle (CT), and the diaphragm. We found that hyperventilation consistently induced hypocapnic central apnea in all nine lambs in hyperoxic conditions [30% inspiratory fraction of O2 (FIO2)], in eight of nine lambs in normoxia or mild hypoxia (15 and 21% FIO2), and in four of seven lambs in hypoxia (8% FIO2). During baseline room air breathing, there was no glottic adductor muscle expiratory EMG activity or expiratory airflow braking. Continuous TA EMG activity began early during hyperventilation and continued throughout the central apnea, regardless of PaO2. The first subsequent breathing efforts were marked by expiratory flow braking and expiratory activity of the TA. The LCA and the TA demonstrated the same EMG activity pattern.(ABSTRACT TRUNCATED AT 250 WORDS)

Posterior Cricoarytenoid Myoplasty with Medialization Thyroplasty in the Management of Refractory Abductor Spasmodic Dysphonia

2003 ◽  
Vol 112 (4) ◽  
pp. 303-306 ◽  
Author(s):  
Gary Y. Shaw ◽  
Phillip R. Sechtem ◽  
Benji Rideout
Keyword(s):  
Gold Standard ◽  
Spasmodic Dysphonia ◽  
Satisfaction Survey ◽  
Cricothyroid Muscle ◽  
Medialization Thyroplasty ◽  
Laryngeal Dystonia ◽  
Posterior Cricoarytenoid Muscle ◽  
Speech Pathologist ◽  
Posterior Cricoarytenoid ◽  
Uniform Reduction

Of the approximately 100,000 Americans with primary (idiopathic) laryngeal dystonia, 10% to 15% are thought to have the abductor form. Botulinum A toxin injected into the posterior cricoarytenoid muscle and/or cricothyroid muscle has been employed as the “gold standard” for therapeutic management; however, successful results are significantly less frequent than with injections for the adductor form. This report describes a new phonosurgical procedure, posterior cricoarytenoid myoplasty with medialization thyroplasty, designed for these refractory patients. Posterior cricoarytenoid myoplasty with medialization thyroplasty has been performed on 3 patients with abductor laryngeal dystonia. All patients had failed at least 5 previous botulinum A injections to the posterior cricoarytenoid and cricothyroid muscles. All patients underwent preoperative and 3 postoperative (2 weeks, 3 months, and 1 year) phonatory analyses. Analysis consisted of recording an aloud reading of a standard passage while a blinded trained speech pathologist counted prolonged voiceless consonants. The patients also completed a satisfaction survey at 1 year. The results demonstrated significant, long-lasting, uniform reduction in breathy breaks in all subjects. The participants all judged their symptoms as greatly improved. Bilateral procedures may be necessary, but should be staged to prevent possible airway compromise. When applied appropriately, posterior cricoarytenoid myoplasty with medialization thyroplasty is a viable tool in the management of refractory abductor laryngeal dystonia.

Respiratory Activity of the Rat Posterior Cricoarytenoid Muscle

1997 ◽  
Vol 106 (11) ◽  
pp. 897-901 ◽  
Author(s):  
Robert G. Berkowitz ◽  
John Chalmers ◽  
Qi-Jian Sun ◽  
Paul M. Pilowsky
Keyword(s):  
Phrenic Nerve ◽  
Muscle Activity ◽  
Electrophysiological Study ◽  
Emg Activity ◽  
Diaphragmatic Muscle ◽  
Posterior Cricoarytenoid Muscle ◽  
Inspiratory Activity ◽  
Intramuscular Nerve ◽  
Posterior Cricoarytenoid ◽  
Nerve Discharge

An anatomic and electrophysiological study of the rat posterior cricoarytenoid (PCA) muscle is described. The intramuscular nerve distribution of the PCA branch of the recurrent laryngeal nerve was demonstrated by a modified Sihler's stain. The nerve to the PCA was found to terminate in superior and inferior branches with a distribution that appeared to be confined to the PCA muscle. Electromyography (EMG) recordings of PCA muscle activity in anesthetized rats were obtained under stereotaxic control together with measurement of phrenic nerve discharge. A total of 151 recordings were made in 7 PCA muscles from 4 rats. Phasic inspiratory activity with a waveform similar to that of phrenic nerve discharge was found in 134 recordings, while a biphasic pattern with both inspiratory and post-inspiratory peaks was recorded from random sites within the PCA muscle on 17 occasions. The PCA EMG activity commenced 24.6 ± 2.2 milliseconds (p < .0001) before phrenic nerve discharge. The results are in accord with findings of earlier studies that show that PCA muscle activity commences prior to inspiratory airflow and diaphragmatic muscle activity. The data suggest that PCA and diaphragm motoneurons share common or similar medullary pre-motoneurons. The earlier onset of PCA muscle activity may indicate a role for medullary pre-inspiratory neurons in initiating PCA activity.

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